Emerging role of endoscopic ultrasound-guided liver biopsy.

We read with interest the recent guidelines by Neuberger et al 1 and would like to congratulate the authors on a comprehensive review of the use of liver biopsy in clinical practice. However, we were disappointed that the emerging role of endoscopic ultrasound-guided liver biopsy (EUS-LB) was understated in the recommendations. EUS-LB has been shown to give histological diagnosis rates of 93.9% with an adverse event rate of 2.3%,2–5 with less patient discomfort when compared with percutaneous liver biopsy (PC-LB).5 We feel the guidelines should also include other potential benefits of EUS-LB over PC-LB that were not mentioned. The key role of endoscopic ultrasound (EUS) is already well established in assessment of the pancreas and pancreatic lesions.6 Furthermore, EUS is superior to CT for sampling ascites, due to better …